Staging of Prostate Cancer

What is staging of prostate cancer?

When prostate cancer is diagnosed, tests will be performed to determine how much cancer is present, and if the cancer has spread from the prostate to other parts of the body. This is called staging and it is an important step toward planning a treatment program.

What are the different stages of prostate cancer?

The most common way doctors describe the stage of prostate cancer is with the TNM system. In this system, the stage is based on the size and extent of your tumor, whether the lymph nodes are involved, and how far the cancer has spread, as well as the Gleason score and PSA level. Your doctor gets this information from your digital rectal exam (DRE), lab tests, biopsies, and scans.

Stage I

The tumor can't be felt by DRE or seen on ultrasound, but it is discovered because of tests or surgery done for a different reason. It has not spread beyond the prostate. The Gleason score is 6 or less, and the PSA level is less than 10. (T1, N0, M0)

or

The tumor can be felt by DRE or seen on ultrasound, but it is confined to less than half of one side of the prostate. It has not spread beyond the prostate. The Gleason score is 6 or less, and the PSA level is less than 10. (T2a, N0, M0)

Stage IIA

The tumor can't be felt by DRE or seen on ultrasound, but it is discovered because of tests or surgery done for a different reason. It has not spread beyond the prostate. The Gleason score is 7, and the PSA level is less than 20. (T1, N0, M0)

or

The tumor can't be felt by DRE or seen on ultrasound, but it is discovered because of tests or surgery done for a different reason. It has not spread beyond the prostate. The Gleason score is 6 or less, and the PSA level is at least 10 but less than 20. (T1, N0, M0)

or

The tumor can be felt by DRE or seen on ultrasound, but it is confined to one side of the prostate. It has not spread beyond the prostate. The Gleason score is 7 or less, and the PSA level is less than 20. (T2a or T2b, N0, M0)

Stage IIB

The tumor can be felt by DRE or seen on ultrasound, and it is in both sides of the prostate. It has not spread beyond the prostate. The Gleason score and PSA can be any number. (T2c, N0, M0)

or

The tumor has not spread beyond the prostate. The PSA level is 20 or higher. The Gleason score can be any number. (T1 or T2, N0, M0)

or

The tumor has not spread beyond the prostate. The Gleason score is 8 or higher. The PSA can be any number. (T1 or T2, N0, M0)

Stage III

The tumor has spread outside of the prostate. It may involve some of the glands called seminal vesicles, which produce semen. It has not spread to your lymph nodes or anywhere else in your body. The Gleason score and PSA can be any number. (T3, N0, M0)

Stage IV

The tumor has spread outside of the prostate and seminal vesicles and has reached nearby tissues such as the bladder's external sphincter (a muscle that helps control urination), rectum, and/or the wall of the pelvis. It has not spread to the lymph nodes or distant parts of the body. The Gleason score and PSA can be any number. (T4, N0, M0)

or

The cancer has spread to the lymph nodes, but it has not spread to distant parts of the body. The Gleason score and PSA can be any number. (Any T, N1, M0)

or

The cancer has spread to distant parts of the body. The Gleason score and PSA can be any number. (Any T, any N, M1)